[Comparison of TD-fentanyl with sustained-release morphine in the pain treatment of patients with lung cancer]

Author(s): Ozturk T, Karadibak K, Catal D, Cakan A, Tugsavul F, Cirak K

Affiliation(s): Department of Anaesthesiology, Dr. Suat Seren Teaching and Research Hospital, Izmir, Turkey. ozturktulun@yahoo.com

Publication date & source: 2008-07, Agri., 20(3):20-5.

Publication type: English Abstract; Randomized Controlled Trial

Comparison of TD-fentanyl with sustained-release morphine in the pain treatment of patients with lung cancer AIM: The aim of this randomized and controlled trial was to evaluate the analgesic efficacy of trans-dermal fentanyl (TDF) and sustained-release oral morphine (SRM) primarily and their side effects secondarily, in patients with chronic lung cancer-related pain. MATERIAL-METHODS: According to three step analgesic guidelines recommended by the World Health Organization, 50 chronic lung cancer patients requiring third line therapy were enrolled and received either TDF patch (Grup F, n=25) or SRM per orally (Grup M, n=25) for 15 days. Patients were assessed in view to numeric rating scale of their pain, as well as the drugs' side effects like constipation, nausea-vomiting, urinary retention and urticaria, hypoventilation. RESULTS: Pain scores were similar for both groups at the beginning (p>0.05). While significantly lower pain scores were achieved on the 7th and 15th days compared to those of initial values in Group F and Group M patients (p<0.001); these decreases did not reach statistical significance between the groups (p>0.05). Compared to Group M, constipation was significantly lower in Group F (14 patients and 64% vs. 6 patients and 27%, respectively) (p=0.03). However, the frequencies of nausea-vomiting, urinary retention and urticaria were different between the groups (p>0.5). None of the patients developed hypoventilation. CONCLUSION: Both TDF and SRM are safe and effective analgesics for the management of chronic cancer pain. However, TDF is associated with significantly less constipation rate than that of with SRM.